Organization Active NPI

Fifth Street Counseling Center IV, Inc

  • Community/Behavioral Health Agency
  • Plantation, FL
National Provider Identifier
1215277199
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FIFTH STREET COUNSELING CENTER IV, INC
Practice address
4121 NW 5TH St
206
Plantation, FL 33317-2120
Phone
(954) 797-5222
Fax
(954) 797-7677
NPI assigned
Feb 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kathleen M Rhodes, LMFTNPI 1104153311
Title
President
Phone
(954) 797-5222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4121 NW 5TH St
206
Plantation, FL 33317-2120

Mailing address

4121 NW 5TH St
206
Plantation, FL 33317-2120
Phone (954) 797-5222

Other practice location 1

130 E McNab Rd Ste 206
Pompano Beach, FL 33060-9240
Phone (954) 797-5222

Other practice location 2

6151 Miramar Pkwy Ste 213
Miramar, FL 33023-3974
Phone (954) 797-5222

Other identifiers 1

IdentifierTypeStateIssuer
1104153311OtherFLBLUE CROSS BLUE SHIELD TYPE 1

National Provider Directory

National Provider Directory

Locations

6151 Miramar Pkwy
Ste 213
Miramar, FL 33023
Phone (561) 735-7610

4121 NW 5th St
Ste 206
Plantation, FL 33317
Phone (954) 797-5222

130 E McNab Rd
Ste 206
Pompano Beach, FL 33060
Phone (954) 797-5222

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1215277199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 NW 5TH ST",
            "address_2": "206",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172120",
            "telephone_number": "954-797-5222",
            "fax_number": "954-797-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 NW 5TH ST",
            "address_2": "206",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172120",
            "telephone_number": "954-797-5222",
            "fax_number": "954-797-7677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 E McNab Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330609240",
            "country_code": "US",
            "telephone_number": "954-797-5222",
            "fax_number": "954-797-7677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6151 Miramar Pkwy Ste 213",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330233974",
            "country_code": "US",
            "telephone_number": "954-797-5222",
            "fax_number": "954-797-7677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FIFTH STREET COUNSELING CENTER IV, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-28",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "RHODES",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-797-5222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TYPE 1",
            "identifier": "1104153311",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.